1 / 74

eye cases: how?

eye cases: how?. DR. PRANAV BHAGWAT DR. JIJITH C.R. HISTORY TAKING. Allow patient to tell story. Decreased vision. Ask for Onset Duration Uni / Bilateral Distant or near vision Whether the patient wears glasses Diurnal variation. Sudden unilateral loss of vision.

meara
Download Presentation

eye cases: how?

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. eye cases: how? DR. PRANAV BHAGWAT DR. JIJITH C.R.

  2. HISTORY TAKING • Allow patient to tell story.

  3. Decreased vision Ask for • Onset • Duration • Uni / Bilateral • Distant or near vision • Whether the patient wears glasses • Diurnal variation

  4. Sudden unilateral loss of vision • Acute congestive glaucoma • Acute optic neuritis • Acute iridocyclitis • Retinal detachment • Central retinal artery occlusion • Spasm of retinal artery • Vitreous haemorrhage • Injuries

  5. Sudden bilateral loss of vision • Acute methanol toxicity • Hysteria

  6. Reduced vision in the morning, improved in afternoon • Intermittent corneal edema

  7. Cataract Refractory errors Retinopathy-DM, HT Retinal degenerations and RP Chronic iridocyclitis Chronic simple glaucoma Keratitis K opacities Chorio retinitis Chronic optic neuritis MS Drug toxicity Gradual onset loss of vision

  8. Pain in the eye • Type • Onset • Duration • Diurnal variation • Associated complaints e.g., nausea, vomiting, DV

  9. Severe eye pain • Adhimantha • K abrasions and ulcers • Acute iridocyclitis • Panopthalmitis • Acute glaucoma • Scleritis • Episcleritis

  10. Dull Aching pain • Cases with eye strain

  11. Mild eye pain • Corneal FB • Conjunctival FB • Conjunctivitis

  12. Pain around the eye • Pathology of the lid and lacrimal apparatus (eg: stye)

  13. Redness of the eye

  14. Normal eye lid with normal corrected visual acuity • Conjunctivitis • Keratitis • Corneal ulcer • Arjuna • Episcleritis

  15. Abnormal eye lid with normal corrected visual acuity • Ectropion • Entropion • Stye • Blepharitis

  16. Reduced corrected visual acuity without diplopia • Iritis • ACG • K foreign body • K ulcer

  17. Reduced corrected visual acuity with diplopia • Carvernos sinus thrombosis • Orbital cellulitis • Caratico carvernos fistula

  18. Common causes –red eye.

  19. Photophobia • Acute infective or inflammatory lesion of the anterior segment • Recently operated eyes

  20. Watering of the eyes 1)Excessive lacrimation • Keratitis • Uveitis • Glaucoma 2) Epiphora • Mechanical obstruction to drainage- stricture, punctal stenosis & chronic dacryocistitis • Defective orbicularis action

  21. Discharge • Watery-Mild bacterial infection • Serous -viral • Mucoid -mild conjunctivitis • Mucopurulent & purulent- acute pyogenic infection of anterior segment • Serosanguinous- opthalmia neonatrum

  22. Itching • Allergic disoders- phlycten • Episcleritis • Spring catarrh • Allergic blepharo conjunctivitis

  23. Netra daaha • Pittotklishta • Pittaja abhishyanda • Pitta vidagdha drishti.

  24. Foreign body sensation • Presence of FB • Distorted eye lashes- trichiasis, entropion • Conjunctival concretion, calcification • Contact lenses

  25. Black spots in front of eyes • 1) Stationary K scars, lens opacity • 2) Mobile- Vitreous opacities

  26. Headache • Refractive errors • Improperly corrected refractive errors • Zoster

  27. Haloes around light • 1) Early ACG • 2) Acute mucopurulent conjunctivitis • 3) Early stages of cataract

  28. Photopsiae • Irritative lesions of retina • Impending RD

  29. Diplopia • 1) Unioccular- high K astigmatism, subluxated or dislocated lens • 2) Binocular- Squint

  30. Nyctalopia • Vitamin A deficiency • Retinitis pigmentosa • Pathological myopia • Glaucoma

  31. Occupation • Welders • Black smiths- foreign body in the eye • Farmers- fungal keratitis

  32. Medication • 1) Gentamicin, miotics, Atropin- follicular response • 2) Topical anasthetics for long time- severe corneal reactions • 3) Topical and systemic steroids- K disease, cataract, glaucoma • 4) Thiomersal- allergic conjunctivitis, epithelial Keratitis • 5) Benzalkonium- toxic papillary reaction

  33. Past history • Systemic diseases- diabetis mellitus • Arjuna-HT • Iritis- ankylosing spondylitis

  34. History of previous ocular disease • Childhood squint- lazy eye • Blunt injury- traumatic mydriasis ( could be confused with partial third nerve palsy)

  35. Family history • Chronic glaucoma- the incidence nearly 5 times greater in siblings and children of affected patients

  36. Examination of the function of eye

  37. Visual acuity • Snellen’s chart- 6 mtrs • Wear his distant corretion • One eye at a time • 6/60 - 6/6 • CF at 1 meter • Hand movements • PLPR

  38. Jaeger’s test type • N5 to N48

  39. Visual field • 1) Peripheral field- confrontation or perimeter • 2) Central field by scotometery

  40. Colour vision • Ishiahara chart

  41. Ocular and periocular examination • 1) Head posture- Paralytic squint.

  42. Face • Look for • Asymmetry • Signs of paralysis • Obvious skin changes

  43. Orbit • Inspection and palpation

  44. Eye brows • Look for loss of hair- lepromatous leprosy, myxoedema • Depigmentation

  45. Eye lid • 1) Position of the lid margin in relation to cornea- drooping of lids • 2) Thickness of the lid • 3) Swelling • Localised eg) Stye, chalazion • Generalised- Oedema,ecchymosis

  46. Pakshma mandal • Trichiasis- misdirection of lashes • Distichiasis- double row • Madarosis- scantiness • Matting- conjunctivitis

  47. Shuklamandal (conjunctiva & sclera) • 1) Bulbar conjunctiva a) congestion- ciliary/conjunctival

  48. b) Chemosis- c) Subconjunctival haemorrhage d) Pigmentation e) Nodule

More Related